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Quality street

BMJ 1999; 318 doi: http://dx.doi.org/10.1136/bmj.318.7186.758 (Published 20 March 1999) Cite this as: BMJ 1999;318:758

Mark Pownall spoke to Peter Griffiths, director of the Health Quality Service

The UK National Health Service is currently reeling from an unprecedented number of government initiatives which are intended to improve quality and smooth out the largest geographical variations in standards. There are the two new bodies, known by the headline friendly acronyms NICE (the National Institute for Clinical Excellence) and CHImp (Commission for Health Improvement). There is also “clinical governance,” the slippery concept that covers, among other things, clinical audit, promotion of evidence based practice, and the identification and improvement of poor performance.

“The key issue for chief executives, clinical directors, and medical and nursing staff is not health service policies themselves: it is making sense of the new government's ambitions in terms of quality, day to day on the ground,” says Peter Griffiths. Griffiths is now head of the Health Quality Service, an organisation which is attempting to turn the opaque prose of health circulars and policy documents into practical changes to the way doctors and others in the health service organise themselves and their work.

Griffiths has been at the sharp end himself. In 1963, at the age of 18, he joined the NHS in his native Wales straight from school as a junior administrator trainee. In a smooth rise up through the …

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